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In order to study the asymptomatic hepatitis C virus (HCV)-positive blood donors in Israel we analyzed their sera for HCV-RNA using the polymerase chain reaction technique. We found that 0.44% of blood donors were anti-HCV positive. Of those who had repeatedly positive anti-HCV, 82% had evidence of HCV-RNA. One-third of them had elevated liver enzymes, but no detectable cryoglobulins were found in their sera. Although HCV-RNA was detected in the majority of the patients, we were unable to demonstrate vertical or horizontal transmission among the family members of our carrier population.

An analysis of the etiology of acute viral hepatitis in 172 hospitalized patients showed that 70.9% suffered from hepatitis A (HA), 12.2% from hepatitis B (HB), 1.7% from infectious mononucleosis and 15.1% (26 cases) from non-A, non-B hepatitis. Patients who had received blood transfusions during the 6 mo preceding the onset of the disease were not included in the present survey. The male:female ratio in the patients with non-A, non-B hepatitis was 1:88; 73% were Ashkenazic and 27% non-Ashkenazic Jews. The ethnic distribution of patients with non-A, non-B hepatitis was similar to that of patients with HA but differed from that of HB patients (only 41% Ashkenazic). Thirty-eight percent of the non-A, non-B group had had contact with jaundiced patients during the 6 mo preceding the onset of the disease, and 46% were students or soldiers. The clinical course of the disease was, on the whole, milder than that of HB and similar to that of HA. Since many cases of non-A, non-B hepatitis are anicteric, it is concluded that the disease is a significant problem in Israel.

In a prospective study of 50 recipients of HBsAg-negative blood who had undergone cardiac surgery, 4 (8%) developed acute non-A, non-B hepatitis. The patients who developed hepatitis had received significantly more units of blood or blood products than the patients who had no hepatitis. The incubation period of the disease was 4-13 weeks, 3 patients were asymptomatic with peak alaminotransferase (ALT) levels of 320-497 U/1 and 1 patient was jaundiced with a peak ALT of 3,400 U/1. 1 of the patients had high ALT levels after 21 weeks of observation, while 3 patients recovered after 7-10 weeks. It is concluded that non-A, non-B posttransfusion hepatitis in Israel is a medical problem similar to that in the USA and that the clinical picture of the disease varies from a mild asymptomatic to a symptomatic and protracted course.